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Traveling during fertility treatment may feel overwhelming, but it’s definitely doable. While the fertility journey involves many moving parts, careful planning and coordination with your care team can help you take a trip without impacting your treatment. Use the suggestions below to prepare for your travels. 

A Guide to Traveling During Fertility Treatment

Advanced preparation is important when traveling with any medication. Given the complex and time-sensitive nature of fertility treatment, the planning process involves a few more steps.

First, consult your doctor about your plans and make sure your intended travel dates don’t conflict with your treatment. In vitro fertilization (IVF) requires very thorough travel planning, since it entails multiple in-person doctor’s appointments and a very carefully timed egg retrieval. Other treatments such as intrauterine insemination (IUI) may leave more room for flexibility.

Regardless of your specific treatment plan, make sure you are up to date on vaccines and be sure to monitor health-related travel alerts. The CDC advises that women who intend to conceive consult their physician before traveling to a destination with potential exposure to the Zika virus.

Lastly, make sure that you have more than enough of your fertility medication(s) and supplies on hand. Aim for several additional days’ worth. Needles used to inject medications require a prescription in some states, so bring extra to avoid unnecessary hassle.

If you are traveling near an Alto location, same-day delivery of fertility medications and supplies may be available.

Pack your medications and supplies in a carry-on

When traveling by plane, it’s always best to pack important medications and supplies in your carry-on rather than in a checked bag. Bring everything you need to safely administer your medications, including syringes, needles, alcohol swabs, hand sanitizer, gauze, and a sharps disposal container.

While the U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on is 3.4 ounces (100 milliliters), there are exceptions for medications. Bringing needles onto a plane is acceptable when accompanied by injectable medications.

Give yourself extra time to allow for additional screening of these items. The following tips may help you get through security as efficiently as possible.

Inform the TSA officer that you are carrying more than 3.4 ounces of liquid medication before your screening process begins, if applicable.

Bring a copy of your prescription(s) with you.

Keep all medications and supplies in their original packaging.

Put your medications and supplies in a separate, clear bag, as they will need to be separated from the rest of your belongings.

Store your medications at the appropriate temperature

Refrigeration is essential with many fertility medications. (At Alto, we ensure that medications are held at the right temperature before you receive them and guide you on safe at-home storage.)

Many people use frozen gel packs and insulated medication bags to store fertility medications at an appropriate temperature while traveling. (This approach is particularly useful for air travel.) As you finalize your travel plans, verify that your hotel or other accommodation offers access to a refrigerator or mini fridge.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be stressful, let alone traveling during the process, but we’ll be with you every step of the way. We offer free, same-day delivery of medication and supplies right to your doorstep, and our dedicated fertility team is here to answer any questions you may have before your trip.

Interested in learning more about how Alto can support your fertility treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Birth control is essential healthcare, allowing you to prevent pregnancy and take charge of your reproductive health. There are many contraceptive methods to choose from. Learning more about the available options can help you, and in some cases, your partner, make the best decisions for your needs and reproductive goals.

Choosing the Right Birth Control for You | Alto Pharmacy

Read on for an overview of some common birth control methods. Our list focuses on hormonal birth control, which contain synthetic versions of estrogen and progesterone. These two hormones play a significant role in reproduction.

There are other options for contraception that must be used every time you have sex, including condoms and diaphragms. When used correctly, condoms and diaphragms are 98% and 88% effective at preventing pregnancy, respectively.

Permanent birth control is also available in the form of surgical procedures (tubal ligation for women and a vasectomy for men). These procedures must be performed by a healthcare provider. Discuss your options for contraception with your provider.

In addition, there are two options for oral emergency contraception to be taken after unprotected sex: levonorgestrel (Plan B®, Mirena®, Kyleena®) and ulipristal (Ella®). Levonorgestrel is sometimes available without a prescription. Ulipristal is prescription-only.

Like all forms of hormonal birth control, the pill stops ovulation, which is the release of a mature egg from the ovaries during each menstrual cycle. The hormones also thicken cervical mucus, an additional layer of pregnancy prevention that keeps sperm from reaching an egg, should one be released.

There are two types of birth control pills:

Combination pills, or combined oral contraceptives (COCs), contain both estrogen and progestin. (Progestin is a synthetic form of progesterone.) COCs are the more common of the two types.

Progestin-only pills (POPs) contain only progestin.

In both cases, the pills come in a pack and you take one every day.

Many individuals choose the pill for its affordability and effectiveness. However, it must be taken on time every day in order to prevent pregnancy. You may find it helpful to combine taking your birth control with another daily habit such as brushing your teeth, or to set a reminder on your phone. The Alto app has medication management reminders to help you continue with your treatment.

While the pill is 91% effective at preventing pregnancy when taken as prescribed, it does not offer protection against sexually transmitted infections (STIs). If you have an STI or are unsure about a sexual partner’s health history, use condoms every time you have sex to protect your health and your partner’s.

The birth control ring, also referred to as the vaginal ring, consists of a small, flexible ring worn inside of your vagina. It releases hormones, which are absorbed through the vaginal lining, for ongoing pregnancy prevention. Like birth control pills, these hormones prevent ovulation and thicken cervical mucus.

There are two types of birth control rings. NuvaRing® lasts for up to five weeks. It is worn continuously and typically replaced about once a month. It may also be used to skip your period.

An Annovera® ring lasts for a year. You wear it in your vagina for 21 days, take it out for seven days, and then put it back in your vagina to restart the cycle.

A vaginal ring must be used correctly to offer full benefits. That includes replacing it when needed and, in the case of an Annovera ring, taking it out and putting it back in on time. To stay on schedule, set reminders or alarms on your phone, or keep track on a calendar. You can also check out Planned Parenthood’s free birth control reminder app, Spot On.

The birth control ring is prescription-only. It does not offer protection against STIs.

The transdermal contraceptive patch releases estrogen and progestin through the skin and into your body to prevent pregnancy. There are two branded options available in the U.S.: Xulane® and Twirla®. Both patches may be worn on your belly, butt, or back. The Xulane patch can also be worn on your upper arm.

The birth control patch is worn for a total of 21 days. You will need to replace the patch during that time, wearing a new patch each week for three weeks. During the fourth week, you will not wear a patch so that menstrual bleeding may occur. The cycle then restarts.

A patch must be used correctly and on schedule to offer effective pregnancy prevention. Set reminders or alarms on your phone, keep track on a calendar, or use a birth control reminder app.

The birth control patch is prescription-only. It does not offer protection against STIs.

The birth control shot, also referred to as the depo shot or Depo-Provera®, is an injection administered about every three months. It contains progestin and works similarly as the above forms of hormonal birth control to prevent pregnancy.

Many individuals choose the shot for the convenience of the injection schedule and privacy. In order to experience the benefits of the birth control shot, you must stay on track and get a new shot every 12-13 weeks. In most cases, a doctor or nurse will give you the shot. In some cases, you may be able to get a supply of shots from a health center to self-administer.

Use a birth control reminder app or a calendar to stay on track with your injections.

Long-term use of the Depo-Provera shot may increase an individual’s risk for significant and potentially irreversible bone mineral loss. Additionally, it has been associated with an increased risk of breast cancer and is not recommended for those with a known or suspected breast malignancy.

There are two types of longer-term birth control: intrauterine devices (IUDs) and birth control implants. Both methods release hormones into your body to prevent pregnancy.

The implant (Nexplanon®) is a tiny, thin rod implanted into your arm that offers pregnancy prevention for up to five years. It must be implanted in a doctor’s office. If your family planning goals change, a doctor can easily remove the implant before it expires.

The IUD is a small device implanted into your uterus that prevents pregnancy. There are different types of IUDs that offer protection for varying amounts of time.

Hormonal IUDs release progestin to prevent pregnancy. There are four FDA-approved hormonal IUDs in the U.S.:

Paragard® is a copper IUD that does not contain hormones. It prevents pregnancy for up to 12 years.

An IUD must be implanted by a healthcare professional. It is reversible and can be easily removed.

There are many factors to consider when choosing a birth control method. While many individuals find these forms of longer-term birth control more convenient, they are typically more expensive than other forms of contraception.

Timing is essential with many forms of hormonal birth control. We make it easy to stick to the schedule, with free same-day delivery and medication management reminders in the app. In addition, our pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to answer any questions you may have.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Since the beginning, Alto has delivered a full-service pharmacy experience straight to your doorstep. With the launch of Essentials from Alto, we’re now covering even more of your pharmacy needs.

This new offering gives you the option to purchase essential pharmacy items in the Alto app along with your prescription medication, from Tums® and Tylenol® to Covid tests, face masks, and more. It’s all part of our promise to make it easy to prioritize your health and wellness — and to keep you out of long pharmacy lines, of course.

A Full Pharmacy At Your Doorstep: Introducing Essentials from Alto

Since the beginning, Alto has delivered a full-service pharmacy experience straight to your doorstep. With the launch of Essentials from Alto, we’re now covering even more of your pharmacy needs.

This new offering gives you the option to purchase essential pharmacy items in the Alto app along with your prescription medication, from Tums® and Tylenol® to Covid tests, face masks, and more. It’s all part of our promise to make it easy to prioritize your health and wellness — and to keep you out of long pharmacy lines, of course.

Our pharmacy essentials will be offered automatically when you schedule a delivery. Here’s a sneak peak at what to expect.

Essentials from Alto is a curated collection of 50 widely used pharmacy products, conveniently featured in the Alto app. When scheduling a medication delivery, you will be able to browse the selection and add anything you need to your order at no extra cost.

At Alto, customers always come first, with all of our services designed to support your health and wellness. When developing Essentials from Alto, we made sure to include both general use items as well as products related to our core therapeutic areas.

Items available for purchase include but are not limited to:

Allergy & asthma essentials including Claritin®, Flonase®, Benadryl®, and Allegra®

Cough & cold essentials including Nyquil® and Dayquil®

Covid care essentials including rapid antigen tests and medical-grade face masks

Diabetes care essentials including glucose tablets

Digestive health essentials including Tums, Gas-X®, and stool softeners

Pain & fever relief essentials including Advil® and Tylenol

Vitamin & supplement essentials including vitamin D, vitamin C, fish oil, melatonin, and prenatal vitamins

You’ll pay for your essentials along with your prescription medications when you check out in the app, and then schedule them as one delivery.

As a reminder, your payment method options include Apple Pay, FSA/HSA, debit and credit cards, and automatic funds transfer.

To schedule a delivery, pick the day and delivery window that works best and let us know if we should bring your order to your home or office. You can designate a safe place for packages to be left if you won’t be home. 

Get tips for an easy Alto delivery experience.

We designed Essentials from Alto to better serve customers like you, and your feedback is key to improving the experience.

We’ll continue to refine our assortment of pharmacy essentials as we go. If there’s a particular product you’d like to see in the shop, we’re all ears. Send us a message at feedback@alto.com. 

At Alto, we’re more than just a pharmacy — we’re a partner in your health. We go above and beyond to get you the medication you need at the best price possible.

Free, same-day delivery is only the beginning. Our pharmacists are available until 9 pm PST on weeknights and 6 pm PST on weekends to answer any questions you have about your medication. We also offer support with insurance and finding the best price possible on your prescriptions.

Reach out any time through secure in-app messaging or by phone at 1-800-874-5881 to learn more or transfer your prescriptions to Alto.

Traveling with any type of medication requires advanced planning. For those with diabetes, it’s even more imperative to prepare, as there are additional factors to consider like insulin temperature control and TSA screening of diabetes supplies and equipment. Use the suggestions below to make sure you have everything you need to manage your diabetes while away from home.
Consulting your doctor

Traveling With Diabetes: How to Prepare

Traveling with any type of medication requires advanced planning. For those with diabetes, it’s even more imperative to prepare, as there are additional factors to consider like insulin temperature control and TSA screening of diabetes supplies and equipment. Use the suggestions below to make sure you have everything you need to manage your diabetes while away from home.

Schedule an appointment with your diabetes care provider before your trip to make a plan for diabetes management during your travels. Be sure to cover the following:

How will planned activities impact your care needs?

What is the recommended frequency of blood sugar monitoring?

How might changing time zones impact the timing of your insulin dosage? 

Are there any recommended vaccines for your trip?

Keep in mind that eating and physical activity levels can shift during travel — sometimes unexpectedly — so it’s important to prepare for changes in your blood glucose levels.

Travel doesn’t always go as planned, so it’s important to have extra diabetes supplies and medication on hand. A good rule of thumb is to pack twice as many supplies as you think you’ll need and to bring additional paper prescriptions for insulin or other diabetes medications.

If traveling internationally, be mindful that prescription laws vary by country. It’s a good idea to contact the U.S. embassy of the country you’re visiting for more details. Some countries may only allow a 30-day supply for certain medications and/or require you to carry an official prescription or additional information from your doctor with you.

In addition, keep your health insurance card on you throughout the duration of your travels, and review your policy for travel-related details, including whether your destination is included in your provider network.

Here’s a list of potential diabetes medications and supplies to pack. Depending on your diabetes treatment plan, some may not be relevant for you. If you’re unsure what to bring — or how much to bring — ask your diabetes care team.

Enough insulin and syringes for your trip, plus extra

Enough oral medications for your trip, plus extra

Sources of glucose to restore blood glucose levels in the event of low blood sugar, or hypoglycemia, such as over-the-counter glucose tablets (Lift Glucose Chews, TRUEplus® Glucose Tablets, ReliOn™ Glucose Tablets), over-the-counter glucose gel (Dex4® Glucose Gel, Glutose™ 15/Glutose™ 45, Insta-Glucose®), or carbohydrate-rich snacks like dried fruits, trail mix, honey, or granola bars

For a detailed list of diabetes management essentials, read How to Prepare a Diabetes Emergency Kit.

If you are traveling on a longer flight with meal service, contact your airline and ask if it’s possible to request a meal tailored to your dietary needs, with low sugar, fat, and cholesterol values. Be sure to have other food on hand in case there are any issues with your meal.

Make sure others know that you have diabetes. If traveling with others, inform them of what to do in the event of a hypoglycemia emergency. If traveling alone, have a medical ID bracelet or another form of identification that communicates your diabetes diagnosis. You should also carry a list of your current medications and doses and provider contact information.

It’s always best to pack important medications in your carry-on rather than in a checked bag. Since you’ll be bringing additional supplies and medications as a back-up, make sure at least half of them are in your carry-on.

While the U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on bag is 3.4 ounces (100 milliliters), there are exceptions for diabetes supplies and medications. Give yourself extra time to allow for additional screening of these items. If you use a diabetes device attached to your body, such as an insulin pump or glucose monitor, it will likely require additional screening as well.

Here are some tips that may help you get through security as efficiently as possible.

Consider printing a TSA notification card describing your condition to hand to the TSA officer.

If you take insulin, make sure you have what you need to keep it refrigerated. Keep in mind that insulin should not be held at extreme temperatures and storing it in an ice pack can make it unusable. Many people with diabetes use insulated medication bags to hold insulin at an appropriate temperature when traveling.

Read Taking Care of Your Insulin to learn more about safe insulin storage.

It’s important to stay proactive about your diabetes management. There may be times when you have to check your blood sugar even more frequently, for example, if you are more active than usual, and adjust your meal plans accordingly. Keep in mind that hot weather can also impact your body’s insulin use and your blood sugar levels.

Continue to hold insulin at an appropriate temperature during your travels and avoid leaving it in a hot car — including the glove compartment or trunk — or anywhere with direct sunlight. The same applies to other diabetes supplies like your blood sugar monitor and insulin pump.

If you are going on a longer trip, with a full itinerary, try to take it easy for the first few days as your body adjusts. Remember to bring snacks with you on busy days with long activities.

A diabetes pharmacy partner you can rely on

At Alto, we make it as easy as possible to manage your diabetes when traveling. We offer free, same-day delivery of medication and supplies right to your doorstep, and our dedicated diabetes team is here to answer any questions you may have before your trip.

Reach out any time via in-app secure messaging or phone at 1-800-874-5881.

Last summer, Moringa Fellows Irma Figueroa and Adrian Mendez joined Alto as the company’s second batch of engineering interns. Here, they share their learnings, accomplishments, and advice for future Alto interns.

Two Engineering Interns Weigh In: What to Expect From Your Alto Internship

The Moringa tree flourishes almost anywhere it’s planted. It’s hardy, fast-growing, and resistant to drought — an apt metaphor for the two interns who joined us from the Moringa Fellowship program last summer.

“Before Alto, I had never actually contributed to a large codebase,” admits Irma Figueroa, an intern on the Supply Chain Team. By the end of their three-month internships, however, Irma and fellow intern Adrian Mendez had shipped impactful features for Alto’s internal pharmacy management system and customer-facing app that are still in production today.

Below, we chat with Irma and Adrian to learn what it was like interning at Alto, which projects they worked on, and what advice they’d give to future interns. 

Adrian, who interned on the Patients Team before returning to join as a full-time software engineer last fall, was surprised by the freedom he had to choose what he worked on during his internship: “Early on, my manager gave me a rundown of the projects the team was juggling and the option to choose which one interested me the most,” he says. “I was able to decide the kind of experience I was going to have.” 

Adrian adds that meetings with his mentor evolved over the course of his internship, as he became more familiar with the codebase: “From the start, we had weekly meetings to talk about whatever was on my mind. Those meetings started off as general advice and questions and turned into more time to pair or run things by each other.”

Because both Adrian and his mentor were working on the same, long-term project, some of those meetings were also dedicated to project work. This included “sitting with [my mentor] while creating the project outline, pairing on larger tasks, and syncing up on progress.” 

Which projects did you work on during your internship? 

On the Supply Chain Team, Irma was tasked with a unique inventory challenge: Technicians at our production pharmacy locations use handheld scanners to scan the barcodes on newly-received inventory. Our technicians often need to scan hundreds of inventory items at a time — making it all too easy to lose track of which items have been successfully scanned onto which shelves. 

“I created a reusable counter component, displayed in the header of the scanner app, that would represent the number of items scanned into a shelf.” Irma says. The best part? Getting to test the handheld scanner herself. “I really enjoyed using the scanner for testing purposes. It was rewarding to see my code in action and definitely super fun!” 

On the Patients Team, Adrian worked on a project to add a homescreen to the customer-facing native app. Previously, the app dropped users into a list of all their active medications, which made it difficult to know where to look or what to do next. The new homescreen allows users to schedule the prescriptions most relevant to them and to view or edit any upcoming deliveries. 

“The first step was to create new additions to the design system — essentially taking the designs and extracting system-wide components. After that, the fun part was taking all those components and putting them together like building blocks!” Adrian says.

It was especially rewarding, he adds, to have been part of the project from start to finish. “I joined right as the design phase started, and I was there mostly every step of the way. For how short my time here was, having helped create this landmark project is really cool to think about.” 

What advice would you give to future Alto interns?

Irma and Adrian agree: Don’t be afraid to ask for help. “You'll often feel challenged and possibly intimidated, but be patient with yourself and remember you have an entire team of experienced engineers ready to help,” Irma says. 

“Everyone at Alto is more than willing to help you out, so don't be afraid to ask questions! You're on the same ship as everyone else, so your success equals everyone’s success,” Adrian adds. “Just remember that your work got you here, and they wouldn't have invited you if they thought you couldn't handle it. They made an investment in your ability to grow, so stay curious.” 

Interested in interning at Alto? Check out our careers page here.

Whether traveling domestically or abroad, arriving at your destination with the medication you need is rarely as simple as packing it in your suitcase. From TSA compliance to temperature control, there are many factors to consider when traveling with medication — not to mention getting enough of a supply for the whole trip (plus extra, just in case).

Managing Your Medications While Traveling | Alto Pharmacy

Planning is key to managing your prescriptions and staying on top of your health needs while you’re away from home. Follow these tips to prepare for your next trip.

Research your destination’s medication laws

Many medications that are legal in the U.S. aren’t allowed in other countries. And it’s not only prescription medications: even over-the-counter treatment options may not be permitted in some destinations.

To avoid any unwelcome surprises while going through customs — or any missed doses — confirm that your medications are legal in the country you’re visiting. As a starting point, check with that country’s U.S. embassy. Consider that some countries may only allow a 30-day supply for certain medications and/or require you to carry an official prescription or additional information from your doctor with you. If you learn that your medication is not allowed at your destination, contact your healthcare provider to discuss your options.

There are legal considerations to be aware of even if you are traveling within the U.S. For example, you may be able to fill certain prescriptions out of state if you lose your medication or forget to order a refill before your trip, but the laws vary by state and there are often restrictions on controlled substances. Do your research in advance and make sure to prepare for any scenario.

Make sure you have enough of your medication

Unforeseen changes can happen when traveling, so it’s important to have more than enough medication on hand. Aim for an additional week or two’s supply. Allow yourself plenty of time to fill your prescription(s) before your trip. Depending on when you are due for a refill, you may need to request an early refill authorization from your insurance company — sometimes referred to as a vacation override — in order to get your medication in advance. (Alto can help with this!) 

In addition, make sure you’re prepared in the event that you misplace your medication during your trip. Write down the generic names of your medications, which may be more commonly available at pharmacies in other countries.

Lost luggage can be more than an inconvenience if your medication is in your checked bag, so always pack any important medications in your carry-on. This does mean you’ll have to be mindful of security requirements, particularly if carrying liquid medication. The U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on bag is 3.4 ounces (100 milliliters), but there are exceptions for liquid medications. For the easiest travel experience, inform the TSA officer that you are carrying more than 3.4 ounces of liquid medication before your screening process begins, and be aware that additional screening of your medication may be required.

Keep your medications in their original packaging to avoid any issues when passing through security or customs. You may want to bring an official prescription or other documentation of your medical condition as an additional precaution, especially if you take a controlled substance or are traveling abroad.

Many medications lose their effectiveness if held at extreme temperatures, which is another reason to put your medication in your carry-on, as a plane’s luggage compartment can be very cold. If you take a medication that requires refrigeration like insulin, make sure you have what you need to hold your medication at an appropriate temperature.

Many people with diabetes use insulated medication bags to refrigerate insulin when traveling. Read ‘How to Prepare a Diabetes Emergency Kit’ for more information on the diabetes essentials to bring on a trip.

If you’re traveling far from home, anticipate how time zone changes may impact your medication schedule. Before your trip, ask your doctor how to handle the time zone shift and what to do if you accidentally miss a dose — some medications have more flexible timing of doses than others. 

Getting a last-minute refill before a trip is low stress with a flexible pharmacy partner like Alto. We offer free same-day delivery seven days a week, with the convenience of choosing the best delivery window for your schedule. And we’ll work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Managing Your Medications While Traveling

Face and fingerprint ID login is a convenient, seamless way to gain app access on a mobile device. Instead of typing in a lengthy, hard-to-remember username and password, many apps allow you login with just a quick scan of your face or fingerprint (also known as biometrics).

Considerations and Approaches for Implementing Biometric Login: Part 1

It's a desirable feature for both our end user and the Patients Team here at Alto — we want to make it as easy as possible for users to log in while also performing more frequent authentication checks. Improve the user experience and the security of our app? Sounds like a win-win.

As an engineer, implementing biometric login might seem easy, as mobile devices already capture, manage, and encrypt biometric data and expose APIs for app developers like myself to initiate a biometric scan. All I need to do is call that API and wait to hear if the scan is successful or not. What isn't as simple, though, is figuring out what to actually do with a successful biometric scan response. What does a successful scan mean, and how does that relate to the username and password credentials that users currently use to access our app?

This post walks through the decision points we encountered while implementing biometric login and how our healthcare privacy concerns influenced the final implementation approach.

Prior to implementing biometric login, the only way for users to access the Alto app was with email (username) and password. A valid email and password generates a session, which expires at some frequency. Once the session expires, the user must re-enter their email and password to regain access to the app.

From the beginning, we knew that biometrics would need to be built with our existing email and password session management in mind. This is made clear in the Apple developer docs: "Use biometrics as a supplement to something you’re already doing. Don’t depend on biometrics as your only authentication option."

Make it easier for users to login. Nobody likes typing in an email and password — especially on a mobile app. Our goal was to reduce the number of times a user must enter their email and password.

Enhance the security of our app using more frequent authentication checks. As a healthcare app that displays Personal Health Information (PHI), conducting more frequent authorization checks decreases the likelihood of PHI becoming exposed to an unauthorized third party.

Have the ability to revoke biometric access from a particular user. Similarly, we want to be extra careful to ensure that if a device is lost or stolen, we have a fallback plan to invalidate a user's session and protect the user’s PHI. For email and password initiated sessions, this happens when a user changes their password, as any change in login credentials will invalidate all active sessions for that user. We needed a similar contingency plan for biometric login.

There are several ways to use a mobile device's biometrics to authenticate a user, with varying degrees of security.

No server-side authentication. Simply integrate with the device's biometrics as an extra layer of authentication. If the biometric scan is successful, let the user proceed into the app.

Provides an extra check and gives your app a sense of modern polish

No server-side validation means that nothing is being validated against your system, so this is not a good substitute for account authentication. Therefore, even if you add this check, the user should still be prompted to re-enter their email and password at the same frequency as before.

Given this, this approach wouldn't help us reach our goal of reducing the number of times a user must enter their email and password.

This approach is a good fit if your application already has an existing login and session management system, and you want extra authentication checks throughout the user's session without modifying any other part of the system.

Tie biometrics to our existing email and password authentication. Use the user's biometrics to unlock an encrypted version of their email and password credentials. When a user sets up biometric login, store the user's login credentials within the device's keystore — the keystore will automatically encrypt the credentials. After a successful biometric scan, retrieve those credentials from the keystore and send them to your existing login API.

Still easy to implement, no backend changes needed

Biometric scan can be used in place of entering an email and password

Changing email and password credentials will revoke biometric access: if a user changes their credentials, their biometrics will access stale credentials and fail to login. (This is somewhat of a con as well — it provides a poor user experience, but it's an edge case that should happen infrequently.)

There is still only one way for a user to authenticate server-side, but now two ways to pass server-side authentication — essentially weakening your app's existing account security.

This approach effectively hands out internal login credentials to third party storage. While not a huge risk considering a device's secure storage is encrypted and trusted by most users, it’s not necessarily a best practice either.

This approach is a good fit if your application doesn't contain sensitive data, and your goal is to make it more convenient for a user to login by replacing email and password with a biometric scan.

Create a separate authentication mechanism for biometrics. Introduce a new authentication mechanism specifically for biometrics, resulting in two independent forms of server-side session authentication: email with password and biometrics. The implementation could look like generating a keypair or a shared secret to save and validate against the server whenever a user attempts to login with biometrics.

Biometrics is now tied to its own secure server-side authentication mechanism, which means it can be used independently of email/password (or even replace it, if you choose to).

Two layers of authentication adds security to the app. Not only does a user need a valid email/password session, they also need a valid biometric session.

It provides fine-grain control over a user's biometric session. You can invalidate a user's biometric session by invalidating the public key and can even invalidate a biometric session without impacting an email-and-password session if needed.

Requires building and maintaining a separate authentication mechanism

This approach is a good fit if your application contains sensitive data (e.g. PHI or financial information), and your goals are to make it both more convenient for a user to login by replacing email and password with a biometric scan while also strengthening the security of your account management system.

Because we are a healthcare company dealing with sensitive data, we chose this last path. It required greater engineering investment, but we agreed it was imperative that we maintain a secure system while introducing biometric login for users.

In part 2, we talk implementation details, including the library we used, code snippets, and questions to consider before you get started. Interested in learning more about engineering at Alto? Follow us on LinkedIn.

Our pharamcists explain more about the various types of allergies, how an allergist or immunologist can help, and when it may be time to see one.

When to See a Healthcare Specialist for Allergy Treatment

There’s a wide spectrum of allergy conditions, from mild seasonal allergies to more severe symptoms that persist year round. It makes sense, then, that there is also a spectrum of allergy treatment options.

Some people are able to manage mild symptoms with occasional use of over-the-counter allergy medications, including oral antihistamines like Claritin®, Allegra®, and Zyrtec®; decongestants like Afrin® and Sudafed®; and nasal corticosteroids like Flonase® and Nasacort®. But if allergies impact your focus at work or school, or prevent you from living a more active life, you may consider consulting with a healthcare professional about treatment options.

In addition to your primary care provider, there are specialists with extensive training in allergy treatment such as allergists and immunologists. They can help you better understand the cause of your symptoms so that you can determine a more effective allergy treatment plan. Below, we explain more about the various types of allergies, how an allergist or immunologist can help, and when it may be time to see one.

There are many types of allergies, but all are produced by a reaction in your immune system. In people with allergies, the immune system interprets substances like dust, pollen, and pet dander as harmful. The immune system then kicks into defense mode, producing antibodies to attack the allergen, which in turn causes symptoms such as wheezing, sneezing, and itching in the eyes, nose, ears, or mouth.

There is often a hereditary component to allergies, so you may be more likely to develop allergies if you have a family history of the condition. While many allergies begin during childhood, they may also occur for the first time in adulthood. Some childhood allergies improve with time, but they can also reappear later in life after years without symptoms.

Here are some of the most common allergy conditions. 

Allergic rhinitis is a broad term for any sinus-related allergic reaction. Symptoms generally include watery eyes; itchy eyes, nose, ears, and mouth; runny or stuffy nose; sneezing; puffy eyes; and post-nasal drip. This reaction can be triggered by a range of allergens and may occur year round or seasonally.

Pollen and outdoor mold typically trigger seasonal allergic rhinitis — sometimes referred to as hay fever — while dust mites, pet dander, and indoor molds can trigger these symptoms at any time of year in certain individuals.

Asthma is a lung condition in which the airways narrow and become inflamed, making it difficult to breathe. Coughing, wheezing, and shortness of breath are some of the most common symptoms. As with allergies, there’s a wide spectrum of severity. For some individuals, asthma symptoms are an occasional annoyance, but for others they can be life-threatening.

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